Bicuspid Aortic Valve: In Search of Valve Dysfunction and Aortic Dilatation Determinants

Bicuspid aortic valve is a common congenital heart abnormality, with moderate familial aggregation (1:8), which develops, with high heterogeneity, valvular dysfunction and aortic dilatation. Complications such as significant valve dysfunction, endocarditis or aortic aneurysm are present in more than 50% of these subjects. Recent imaging studies have shown determinant factors of these complications. Bicuspid aortic valve with right coronary-non coronary cusp fusion has a higher risk of calcification, aortic stenosis and distal ascending aorta and aortic arch dilatation, while in the case of left-right coronary sigmoid fusion it dilates the proximal segment of the aorta, mainly in the presence of aortic regurgitation. Improvement in understanding the pathogenesis of valve degeneration and aortic dilatation will favour new drug therapies, reducing surgical treatment requirements.